HUMPHRY Davy was quick to realise the potential of nitrous oxide gas. At
the beginning of the 19th century he wrote that, besides its powerful
anaesthetic properties, the gas induced pleasurable hallucinations when
inhaled. His friends were so taken with the idea that they talked of setting
up a “nitrous oxide tavern”. Drug use and addiction have been recorded
throughout history, and some researchers have even referred to the need for
intoxication as one of the basic biological drives, along with hunger, thirst
and sex.

Neither is drug use a highly evolved, uniquely human activity. There are
many examples of other animals searching for oblivion, from elephants gorging
on fermented fruit to dogs sniffing the fumes from rotting vegetation until
they lose coordination. Yet human societies tend to frown upon the deliberate
consumption of intoxicating, behaviour-altering substances.

Philip Robson gives a readable and thorough overview of the drugs that are
currently used illegally throughout the world – their effects, treatments for
addiction, their use throughout history and changing social attitudes towards
them. Heroin, for example, is now considered one of the most dangerous drugs.
But 150 years ago, before its addictive nature was fully understood, English
farm workers in the Norfolk fens would turn their noses up at a mug of ale
unless it had a lump of opium in it.

Robson questions the usefulness of the taboos associated with drugs.
Labelling drug use as abnormal has led to the two extreme reactions of
medicalisation (treating it as a disease) and criminalisation. But neither
response has eradicated the use of drugs. And that is Robson’s point.
Recreational drug use is here to stay, and shutting it in the cupboard with
all the other skeletons will not make it go away.

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Why do people use drugs? There is no simple explanation, says Robson. But
much research has focused on psychological factors, producing endless
correlations. Low self-esteem, for example, is common in those with drug
problems. But is that cause or effect? Robson rightly advises caution in
interpreting the data.

What Robson highlights is that treatments will be effective only when they
draw on all the contributing factors – biological, psychological and
sociocultural. In the legalisation debate, he offers a well-reasoned argument
in favour of controlled availability of recreational drugs and a more “user-
friendly” approach to addicts.

Robson asks as many questions as he answers. He does not attempt to find a
comprehensive explanation of addiction but he does imply that it will evade us
unless the strands of research are drawn together. Meanwhile there are tricky
moral questions to be answered. Politicians take note.